Ultrasound learning cases are compiled in sets of software packages according to topic. Education Modules are currently available for Abdomen, Obstetrics, Gynecology, Transvaginal Gynecology, Transvaginal Obstetrics, Breast, Vascular – Carotid, Neck – Thyroid, and Emergency Medicine – FAST, Biliary, Pelvic, Abdominal Aorta.
The medical content of these modules was developed under the supervision of medical centers from Israel and the USA which include: Thomas Jefferson University Hospital, USA; University of Michigan Medical Center, USA; Meir Medical Center and Sharei-Zedek Medical Center, Israel.
This is the first in a series of three modules. Module 1 is a collection of 40 clinical cases demonstrating ultrasound imaging of the abdomen, including the liver, biliary system, pancreas, spleen and kidneys. These cases demonstrate normal anatomy, anatomical variants and basic pathologies.
Sample Case List:
- Liver examined in multiple planes is normal in size, contour and paranchymal pattern; right kidney shows no evidence of obstruction or disease
- Normal pancreas with homogeneous pattern, normal size and contour
- Normal spleen with homogeneous pattern, normal size and contour
- Right renal cyst in the lateral aspect of the superior pole
- Physiologic hydronephrosis of the left kidney demonstrated by dilatation of the calyces and renal pelvis
The second Module is a collection of abdominal modules with 30 clinical cases of anatomy and pathology of the liver, biliary system and pancreas. Emphasis is placed on the identification of the pathologies.
Sample Case List:
- Left adrenal metastasis at the medial aspect of the spleen which has displaced the left kidney postero-laterally
- Multiple hepatic cysts in the right lobe of the liver with a solid mass in the inferior aspect of the right lobe
- Thrombosis within the splenic, main portal and left portal veins
- Hypoechoic mass in the body and proximal tail of the pancreas as well as a small mass adjacent to the common hepatic artery and celiac trunk, possibly representing lymphadenopathy
- Obstructive jaundice with dilated common hepatic and common bile ducts due to multiple gallstones
Abdomen – Module 3 – Urinary Tract
The third module is a collection of 31 clinical cases focusing on the lower pelvis. A wide range of normal and pathological conditions are demonstrated containing the kidneys, bladder, ureters and prostate. This module is appropriate for both introductory and experienced users.
Sample Case List:
- A fusiform dilated right ureter containing a small hypoechoic mass with calcifications
- A large predominately hyperechoic renal mass almost completely replacing the renal parenchyma
- A large inhomogeneous prostate which protrudes into the urinary bladder
- Urinary bladder reveals an extensive solid mass in the inferior and left lateral aspect causing bilateral uretal obstruction
- IVC tumor Thrombosis
The first module is a collection of 28 clinical cases which demonstrate transabdominal evaluation of a pregnant woman in all trimesters. The cases include normal pregnancies as well as various fetal anomalies.
Sample Case List:
- 7 week fetus, visible yolk sac, right ovary with a corpus luteum cyst
- Normal 16 week fetus in oblique vertex position
- 19 week fetus, averaged from BPD, head circumference and femur length
- 25 week fetus: part 1-fetal chest, abdomen and extremities, part 2-fetal head and neck
- Large septated mass at posterior aspect of fetal head and neck with abdominal edema
Obstetrics – Module 2 – Interpretation
The second module takes a fresh approach to simulation based interactive learning. Intended for UltraSim users with previous clinical obstetrical ultrasound experience, it is designed to help improve critical thinking in case interpretation and provide significant exposure to common sonographic imaging pitfalls and how to avoid them.
Sample Case List:
- 27 Week Fetus – Spina Bifida
- 24 Week Fetus – Hydronephrosis
- 12 Week Fetus – Normal Triplet Pregnancy
- 12 Week Fetus – Abnormal Triplet Pregnancy
- 20 Week Fetus – Hydrops
This module is a collection of 30 clinical cases demonstrating transabdominal examination of the uterus and ovaries. The cases include examples of normal anatomy, anatomical variants and basic pathologies.
Sample Case List:
- Normal uterus and left ovary with an endometrioma in the left adnexal and cul-de-sac area
- Normal uterus and ovaries with prominent EMC, multiple follicles in right ovary
- Large right dermoid cyst, displaced right ovary
- Large uterine fibroid extending from the right lateral aspect of the uterus
- Pediatric examination showing normal uterus and ovaries
Transvaginal – Module 1 – Gynecology
The first module is a collection of 30 cases demonstrating transvaginal examination of the uterus and ovaries. The cases provide examples of normal anatomy, anatomical variants and basic pathologies.
Sample Case List:
- Functional hemorrhagic cyst in the right ovary
- Nabothian cysts in the cervix and Ovarian Hyperstimulation Syndrome (OHS)
- “Adnexal ring” sign adjacent to the right ovary
- Homogeneous hypoechoic mass in the left adnexa and small uterine mass
- Complex right ovarian mass containing a thick septation and internal papillary projections
Transvaginal – Module 2 – Obstetrics
The second module is a collection of 30 cases demonstrating transvaginal evaluation of a pregnant woman in the 1st and 2nd trimesters. The cases include normal pregnancies as well as various fetal anomalies.
Sample Case List:
- Normal Pregnancy, 6-11 Weeks
- Hydatidiform Mole
- Missed Abortion
- Anencephaly, Omphalocele, Dysraphia
- Meckel-Gruber Syndrome
- Incomplete Abortion
- Fetal Demise With Hydrops
- Placenta Percreta
- Eight Week Pregnancy With IUD
- Cystic Hygroma
- Eleven Week Twin
- Pregnancy With Abnormal Third Sac
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The module is a collection of 30 cases demonstrating examination of the breast. The cases provide examples of normal anatomy, anatomical variants and basic pathologies, including cysts, fibroadenomas, malignancies, abscesses and fat necrosis.
Sample Case List:
- Malignant mass in the superior outer quadrant of the left breast
- Anechoic mass, skin thickening, and a prominent duct in the inferior inner quadrant of the left breast
- Complex mass in the superior outer quadrant of the right breast with a fistulous tract coursing into the skin
- Correlation of suspicious mass demonstrated in a mammogram
The module is a first in a series of modules to demonstrate general principles of Color Doppler ultrasound. The UltraSim® operates in full triplex mode with all the functions of today’s ultrasound system. Cases are taken from the arteries of the neck, carotids and vertebral.
Sample Case List:
- Normal left bifurcation, ICA, ECA and vertebral artery
- Normal right CCA and vertebral segments V1, V2, with no evidence of intimal thickening or plaque formation
- Left ICA with several areas of plaque deposits; Color Doppler and spectral analysis demonstrate turbulent flow but normal velocities
- Right ICA stenosis due to a large, heterogeneous plaque; Color Doppler demonstrates flow within the plaque; spectral broadening and elevation of the peak systolic velocity is identified
- Total occlusion of the right ICA with flow reversal at the origin and dampened diastolic flow in the distal ICA and vertebral artery
This module uses the Multi-Volume loading functionality which enables expanded presentation of the anatomy. Included in this module are 16 challenging cases focusing on the student’s/resident’s ability to practice various scanning techniques. This will enable the student/resident to identify normal and abnormal thyroid tissue, evaluate relational anatomy and understand pattern recognition commonly encountered in thyroid disease. This module is suitable for both introductory and experienced users.
Sample Case List:
- An inferior pole hyperechoic solid nodule with calcifications and a thick peripheral halo
- A large solid nodule entirely filling in the right lobe, with extension into the isthmus, causing compression of the remaining thyroid parenchyma
- An enlarged thyroid gland containing multiple nodules with varied size and echogenicity in both lobes and isthmus
- Small-sized thyroid gland with a normal sonographic pattern
- Lateral aspect of the right neck reveals enlarged heterogeneous cervical lymph nodes containing solid components and microcalcifications
Emergency Medicine – Module 1 – FAST
FAST – This is the first in a series of four modules, which incorporates MedSim’s Multi-Volume loading functionality. Multi-Volume loads multiple ultrasound data volumes for each case, providing expanded presentation of the anatomy. This functionality enhances the ability to conduct more complete examinations and improves the educational experience. The FAST Module consists of 2 CDs of which the first CD contains 10 cases each providing sequential scanning of the: Epigastrium, Right Upper Quadrant, Left Upper Quadrant and Pelvis. Each case simulates a complete clinical experience including Patient History and Physical Examination Data. The second CD contains additional learning tasks, which require the user to scan potential fluid collection areas. Included in this CD are Reference Images with Annotations, Sonographic Summaries and Discussions prepared by experts in the field.
Sample Case List:
- Negative FAST
- Small Amount of Fluid in Morrison’s Pouch
- Moderate Amount of Fluid in the Left Chest and Perisplenic Space
- Small Amount of Pericardial Fluid
- Small to Moderate Amount of Fluid throughout the Abdomen and Right Chest
- Increasing Amount of Fluid in the Rectovesical Pouch on Repeated FAST Exams
Emergency Medicine – Module 2 – Biliary
The second module is a collection of 28 clinical cases with learning tasks and educational information. The Module demonstrates normal anatomy and normal variants as well as common biliary tree abnormalities.
Sample Case List:
- Normal Gallbladder
- Anteriorly Positioned Gallbladder
- Normal Gallbladder;
- Dilated Common Bile Duct.
- Septated Gallbladder
- Emphysematous Cholecystitis with Abscess
- Biliary Air, Dilated CBD
- Cholelithiasis, Liver Metastases
Emergency Medicine – Module 3 – Pelvic
This module is a collection of 30 OB/GYN clinical cases mostly transvaginal with several transabdominal cases.
Sample Case List:
- Right Ovary, Teratoma
- Left Ovary, Hemorrhagic Cyst
- Retained Products of Conception
- Left Tubal-Ovarian Abscess
- Endometrial Hyperplasia with Cystic Changes
- Ovarian Hyperstimulation Syndrome
Emergency Medicine – Module 4 – Abdominal Aorta
The fourth module is a collection of 11 cases.
Sample Case List:
- Normal Aorta & Main Branches in Longitudinal View
- Aorta Partially Obscured by Bowel Gas
- Coronal View of Aorta with Bifurcation
- Aortic Aneurysm with Circumferential Thrombus
- Dilated Tortuous Aorta
- Aortic Plaque in Transverse View
